Lipoprotein(a) Levels Are Associated With Subclinical Calcific Aortic Valve Disease in White and Black Individuals

Calcific aortic valve disease (CAVD) is a progressive disorder that encompasses a spectrum of valve pathologies ranging from calcification of valve leaflets to obstruction of blood outflow. Early subclinical stages of CAVD are characterized by aortic valve calcification (AVC), which has historically been considered a benign degenerative condition that occurs with advancing age but is now recognized as a risk factor for cardiovascular disease. Indeed, AVC has been shown to independently predict cardiovascular events, increase risk of fatal coronary heart disease (CHD), and may progress to valve stenosis—a stiffening or narrowing of the aortic valve and most common cause of valve replacement. Several factors have been identified that promote CAVD development that are largely shared with CHD including, but not limited to, age, sex, hypertension, smoking, type II diabetes, hypercholesterolemia, and, more recently, elevated concentrations of lipoprotein (a) [Lp(a)]. See accompanying editorial on page 774